How much rates vary
Facilitymedian $1,380 · 10th to 90th $646 to $8,511Professionalmedian $468 · 10th to 90th $81 to $724
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $13,803.84 | Facility | None | $1,995.26 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $8,912.51 | Professional | None | $562.34 | $562.34 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,148.15 Typical High $4,786.30 | Facility | None | $630.96 | $1,148.15 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $776.25 | Professional | None | $398.11 | $467.74 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $707.95 Typical High $1,148.15 | Professional | 50 · Both sides | $602.56 | $707.95 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,288.25 | Facility | None | $676.08 | $1,000.00 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,951.21 | Facility | None | $676.08 | $1,174.90 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $870.96 | Professional | None | $407.38 | $588.84 | $870.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,951.21 | Facility | None | $691.83 | $1,174.90 | $2,951.21 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $870.96 | Professional | None | $407.38 | $588.84 | $870.96 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $316.23 Typical High $588.84 | Professional | None | $69.18 | $316.23 | $588.84 |
SummaCare Setting Facility Modifier None Typical Low $562.34 Median $588.84 Typical High $660.69 | Facility | None | $562.34 | $588.84 | $660.69 |
SummaCare Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $707.95 | Professional | None | $501.19 | $501.19 | $707.95 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $5,888.44 | Facility | None | $691.83 | $1,445.44 | $5,888.44 |
United Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $1,023.29 | Professional | None | $457.09 | $549.54 | $1,023.29 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $912.01 | Professional | 52 · Reduced service | $281.84 | $281.84 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $363.08 | Professional | 53 · Discontinued | $114.82 | $114.82 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $1,380.38 | Professional | 54 · Surgery only | $426.58 | $426.58 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $275.42 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $181.97 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $1,288.25 |
Where Ohio sits
The same service costs 8.5 times more in Wyoming than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 48th of 51
$479
WY $2,512UT $295
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.